What are the responsibilities and job description for the Case Manager position at One to One Health?
Position Summary
The Workers Compensation Case Manager is responsible for supporting the medical treatment of patients with work-related injuries or illnesses, assisting the healthcare provider in managing their care within the workers' compensation system, including documenting medical records, scheduling appointments, coordinating with insurance companies, and ensuring proper claim submission procedures are followed.
Job requirements:
- Taking detailed medical histories, recording vital signs, and performing initial assessments of work-related injuries.
- Setting up exam rooms with necessary supplies and instruments for work-related injury evaluations.
- Helping the physician during physical examinations, documenting findings, and assisting with procedures like wound care or splinting.
- Accurately documenting patient details, including injury descriptions, treatment plans, progress notes, and any limitations or restrictions in a compliant manner.
- Completing necessary paperwork for workers' compensation claims, including initial reports, progress reports, and final status updates, ensuring proper coding and billing practices.
- Communicating with insurance adjusters, obtaining authorizations for treatment, and following up on claim status.
- Providing information regarding work-related injuries, treatment options, and expectations for recovery.
- Coordinating follow-up appointments for injured workers with the physician.
- Adhering to HIPAA regulations and protecting sensitive patient information.
- Other duties as assigned
Skills/Knowledge:
- Excellent organizational and analytical skills
- Strong sense of professionalism.
- Up to date knowledge of workers compensation laws
- Proficiency in relevant software and technology systems.
- Ability to read, write, and communicate the English language.
- Ability to effectively communicate both orally and in writing
- Ability to follow written or verbal step-by-step instructions
- Ability to concentrate, think, and learn
- Ability to hear, see, sit, stoop, kneel, crouch, reach, lift, push and pull
Qualifications/ Experience:
- Highschool diploma or equivalent
- Active CMA or equivalent certification
- Minimum of 2 years prior experience working in the occupational health field.